Causal relationship between prostate cancer and cardiovascular diseases: Univariable and multivariable Mendelian randomization

Abstract

Background Prostate cancer (PCa) and cardiovascular disease (CVD) have a high prevalence worldwide, and the presence of both PCa and CVD signals a poor prognosis; the risk relationship between the two diseases is debatable. Methods This study searched for relationship to PCa and four CVDs using a Mendelian randomisation (MR) approach. Bidirectional causality was investigated using univariate MR investigations. The data were then adjusted for the six major PCa and CVD risk variables using a multivariate MR model and examined for mediated effects. Results PCa was a risk factor for the development of heart failure. Atrial fibrillation and stroke has been a protective effect against the incidence of PCa. Following the adjustment of the multivariate MR model, the association between PCa and heart failure persisted. However, the association between atrial fibrillation and PCa was no longer present after adjustment for BMI. The causal relationship between stroke and PCa was no longer significant in multiple multivariate adjustment models. The mediator MR analysis revealed that atrial fibrillation mediated 15.28% of the causal relationship between BMI and PCa. Conclusions Our study suggests that PCa is a risk factor for heart failure and atrial fibrillation is a protective factor for PCa.